Injured Justin Smith determined to play

A Bay Area orthopedic surgeon said it takes a minimum of 12 weeks for an elite athlete to return to competition after sustaining a partial triceps tear.

Not surprisingly, 49ers defensive tackle Justin Smith, regarded as one of the NFL’s grittiest players, will attempt to defy that diagnosis.

On Friday, Smith said he plans to suit up if the 49ers play next week in a wild-card playoff game, three weeks after he had a bone spur detach when he sustained a partial tear of his left triceps. The bone spur remains in his left elbow.

“Yeah, I’d be ready to play,” Smith told the Sacramento Bee. “Just go with it. That’s all you can do.”

Dr. David Chang, the chief of orthopedic surgery at Alta Bates Summit Medical Center in Oakland, says such an injury takes top athletes a minimum of 12 weeks to return to “game readiness.”

Chang, who is out of the country, discussed Smith’s injury in a series of e-mails. A complete triceps tear, he said, requires surgery and a 12-to-16 week recovery. A partial tear wouldn’t accelerate a typical timetable, even with at least 50 percent of the triceps intact.

“Even with a 50% tear, minimum time of healing is 6 weeks and rehab would have to ensue,” Chang wrote. “So time back is not any shorter without surgery.”

Depending on their severity, partial tears can heal on their own, but surgery is preferred for elite athletes. Jim Harbaugh acknowledged that Smith’s injury will require a procedure.

“It’s something he’ll have to have surgically repaired after the season, either way,” he said.

By playing before he’s fully recovered, Smith risks sustaining a complete tear. If he had immediate surgery, Chang believes, his prognosis would be good, thanks in part to the floating bone spur, which “could be incorporated into the tendon repair and facilitate healing.”

In 2009, Chang performed surgery on Leon Washington when the Seattle running back, then with the Jets, sustained a compound leg fracture in a game at Oakland. Chang is on the medical staff for the Tour of California professional cycling race and is a consulting physician for the Los Angeles Galaxy of Major League Soccer.

He noted that if Smith made a successful return to the field, he wouldn’t be the first athlete to defy a bleak medical diagnosis.

In 2004, Red Sox pitcher Curt Schilling was brilliant in the postseason despite playing with a serious ankle injury. In 2005, Eagles wide receiver Terrell Owens starred in the Super Bowl seven weeks after sustaining a fractured fibula.

Chang said he won’t be shocked if Smith returns nine weeks ahead of a typical schedule, but he does wonder how effective Smith will be with such an injury.

“Typically, athletes are optimistic about playing based on their desire to compete,” Chang wrote. “This is possible, and some have played despite difficult injuries and sometimes against medical advice.”